When moral values are in conflict, where one option rules out another, is described as a phenomenon of moral dilemma. However, on the other hand moral distress is the painful feeling and psychological imbalance faced by nurses who are aware that a correct moral conduct must be followed but are either restricted by supervisors, lack of time, hindrance in institutional policies, or any legal aspect that prevents from conducting the particular activity.
Moral distress can have adverse effects and pose a negative impact on personal and professional development of nurses. A sense of frustration can evolve around nurses, a rage of anger, and a pool of anxiety and guilt can circulate that gives rise to the development of emotional symptoms. All of these factors and more can result in the inability to provide good care to patients.
While addressing the relevance of moral distress, one might need to understand the devastating impact of moral distress and the nursing implications to address those moral distress. 5 moral distress impact is provided below alongside nursing implications.
5 Devastating Impact of Moral Distress on Nurses
Feeling of Frustration
A feeling of frustration can also overcome nurses when they observe a lack of quality patient care. Overcrowding, lack of space, and little or no privacy for patient are the factors which can cause feeling of frustration. Patients and nurses have a unique relationship of care as nurses are the patient’s advocate.
When patients demand something within the boundary of their jursidiction and nurses are unable to provide any help due to their lack of power, it creates frustration alongside emotional exhaustion and depersonalization. The feeling that you know that can help a patient but not able to enforce it can cause embarrasment, misery, and sadness which can be overcome through nursing implications.
Low Job Satisfaction
Other than long working hours, lack of respect, and low compensation, the factors that can result in low job satisfaction can occur due to moral distress. This moral distress if associated with ethically poor ambiance of the hospital, then it can have a serious impact on job satisfaction. It arouses a feeling of not wanting to go back to work when you know that you can do nothing to make patients’ life better which is the most important aspect of your job.
Nurses rasises question for the purpose of their care and ethics of the healthcare institution. Nurses attempts to avoid pain and suffering by making less interaction with patients and relatives, and as a result a less individualized care is processed.
In majority of occasions when nurses fail to cope with moral distress due to their incapacity, they face decline in their confidence on their own abilities and worth which is referred to as self-esteem. Abandonment of job appears to be the only solution for nurses in the view of the triggering situation.
However, since abandonment from the profession turns out to be very costly for the institution, they find ways to develop a culture where nurses could be retained. Self-criticism is often at the peak because nurses feel unsure about their skills in providing a better healthcare for patients.
It tends to occur due to the psychological imbalance experienced by nurses when barriers are imposed upon a behaviour to which the nurses consider adequate. Among the most common manifestations include the feeling of lack of power in making decisions. It makes a nurse feel like they are less valuable to the department and before they could realize a gush of guilt just pours out of the body that limits their self-efficacy.
Other distressful feeling might include resentment alongside anger that repeatedly torments nurses for the things that they could have done or prevented, but were forced in to doing the opposite. Failure to accomodate nursing implications for moral distress, nurses can fall in to depression and feels dissatisfied with their jobs.
It is the second stage of moral distress where the emotional manisfestations are converted in to physical manhifestations. A common example of physical manifestation includes crying, loss of sleep and appetite, muscle pain, nightmares, and a feeling that one is useless in carrying out a certain job.
The characteristics of physical manifestations are similar to burnout which occurs when nurses feel they are responsible for a moral action but obstacles ahead do not let them accomplish their desired task.
5 Nursing Implications for Moral Distress
Nursing educators must be involved in addressing the ethical issues that can arise in nursing profession. Nursing educators must educate nurses to demonstrate the use of their powers alongside adequate behaviours in dealing with these situations.
This nursing implication will prepare nurses for an ethical dialogue with other professionals. Emphasis is also laid upon educational programs with informative interventions about moral distress. As a result, nurses can seek answers to any ethical conflict which compromises the integrity of patients in the healthcare practice.
Communicative dimension nursing implication helps in improving communication between healthcare team members. Multi-professional communication is the key aspect of the particular nursing implication against moral distress because it is the collaborative effort of a team or a group to enforce a certain decision which is lawful and ethical and in the best interest of patients.
It is a technique of how a profession can become an influential profession as various departments strive for a better healthcare ambiance. Senior doctors often take charge of the multi-professional groups.
Ethical rounds are a group discussion forums which are moderated by an ethicist. The practice provides training to nurses in dealing with ethical dilemma or moral conflicts in the workplace. These issues can be related to patient treatment, or any other case studies. Nurses can share their beliefs to other healthcare professionals who have experienced similar dilemmas. This nursing implication will provide a taste of how ethical issues are handled.
For improving organizational dimension, nurses and nursing leaders are hired to reduce the workload of all nurses so they can invest their time in sorting out preventive measures to avoid harms. As a result, nurses are also able to spend time with their patients in providing them a better care and improved service. This nursing implication calls for the improvement in nursing leadership.
Enhancing Nursing Skills
Rather having low self-esteem when failing to provide quality care of patients, nurses must enhance their skills and find alternatives to quality care of patients. Experienced nurses are well-equipped with the art of dealing with low self-esteem, but new nurses often take years in managing the crisis. Therefore, nursing implication is to hone skills that nurses often lack which results in low self-esteem and self-efficacy.